Anybody have experience of surgery while on warfarin?

[Jade]

I am hoping to have some elective surgery but am beginning to stress about how it would work when on warfarin. Has anybody had surgery and what did you do about warfarin?

[Manofmendip]

Yes.

I had heart surgery. You will have to come off Warfarin and onto Fragmin (low molecular weight Heparin), a week before surgery and then start Warfarin again after surgery but keep the Fragmin injections going until your INR is back in range.

Best wishes.

Dave

[Tiggercat]

What ever you do, DON'T let them stop your warfarin without Bridging when it comes to surgery. It may be suggested that you only need cover during the actual surgery, but insist on the LWMH via injection when you stop the warfarin. Take the info APsnotFab linked to, to all your medical appts when discussing surgery.

[jetjetjet]

Both my surgeries I was an 80 % risk factor - ,I started slow withdrawal from warfarin about a week before operation then a day or so after started 120 ml's lovenox for 9 weeks after 1 st operation { they needed to test my S & C proteins}. it was about a week and 1/2 i think on the 2 nd.-- jet

[Lure2]

Thank you APsnotFab for this important link. Kerstin

[tim47]

St T's have a protocol for it and though I needed it for an non-surgical investigation, I insisted my local hospital followed the procedure. (Nowadays I think I could manage it at home either side of the procedure rather than the week I had as an inpatient ) Just make sure your surgeon is aware of your specific anti-coagulation needs, and that the steps they will take are explained to you, and that you feel confident about them. (copy the information from above). Keep reminding them and don't be afraid to demand full explanations.

If you have Hughes it must be catered for and warfarin not just suspended for a few days. On the plus side, hospitals are getting more used to dealing with us and management is becoming much better controlled. Just make them understand it needs planning for..

[YvonneW]

I also had elective surgery last year. The clinical nurse specialist at St Thomas' was brilliant & I had a regime printed out of when and how to stop warfarin, start clexane etc. I showed it to the nurse specialist at my anti-coag support clinic at the local hospital where I was having the op and also to the surgeons at my pre-op clinic appointments. It was fine. It took a while to get my INR back up post-op and I was on clexane for the duration - so purple tummy, but no TIAs. Hope it goes well for you, Jade.

[Rhian]

Hi, I recently had surgery for the first time since being on warfarin. I felt nervous but everything went OK. Stopped warfarin for five days before op and had clexane injections up until the night before. Continued with clexane after op and re-started warfarin day after the op. Continued with clexane and warfarin until back within therapeutic range. Hope everything goes well. whitelady

[Jade]

Thank you all for your advice. Does anybody know if it's possible to get information from St T's on the regime. I see Professor Hughes at London Bridge but I know the NHS don't like stuff from private docs. Plus I don't have use of an anti coagulation clinic.

[Zezes-nan]

I had a non surgical investigation which required me to have a general anaesthetic, showed the consultant the 'bridging regime' given to me by the haematologist at Central Middlesex Hospital and they decided that as look as I was in my desired range I could continue with the warfarin as they didn't intend to do any surgery.

Good luck with your procedure.

[Gingermeggs48]

I have had several surgery jobs since being fitted an artificial Aortic valve back in 2001, and each time been taken off warfarin via a constant connection to minute by minute drip supply into the vein of Hepron. At each instance for me it has only taken 4 days to get totally off the Warfarin and the same to work back onto it. It is important to have the drip feed dose of the hepron or whatever other chemical is used, adjusted daily as your INR effect from the changed daily dose of warfarin takes effect. If this is not done then serious bleeding consequences will occur as happened to me or the opposite while they are taking you off warfarin.

Also when you get home from hospital and back onto a more real food diet you may well find your dose needs major change as you get settled onto your regular diet. This also has happened to me with an in hospital stable warfarin dose of 4.5mg a day and then get home onto my healthy food diet and the warfarin dose had to be raised to over 8mg a day! within weeks

Check out my story on my web site ;- warfarinwizard.com

where you can also access the book or get it on Kindle;-

Warfarin How to live with it and reclaim your Health, Vitality and your life.

In this book All Warfarin users can learn a whole host of useful insights into how to better live in harmony with Warfarin.

[Lure2]

When were you diagnosed APS?

[Lexi_Img]

Yes I did the same as Dave. You must be in touch with the right professionals before your bridging. Good luck

Lexi-ingrm